Heterogeneous 18F-FDG uptake in recurrent respiratory papillomatosis

Recurrent respiratory papillomatosis (RRP) describes an infection of the upper aerodigestive tract by the human papilloma virus most commonly affecting the larynx with rare lung involvement in 1%-2% of affected patients. We describe an unusual case of a 28-year-old male patient with a longstanding history of RRP where a whole-body PET/CT obtained for disease staging revealed multiple cavitary pulmonary nodules in addition to the more typical tracheobronchial papillomas. In the case described herein, we report heterogeneous uptake of 18F-FDG among these RRP lesions, suggesting significant unexpected variability in the underlying metabolic behavior of these lesions.